Approved Minutes of April 23, 2025

Browse Search

MINUTES ORANGE COUNTY BOARD OF HEALTH April 23, 2025 • One of the participants shared that he is lacking community support, with little support from family and friends to help him during his transition out of incarceration, and that he has severe mental health issues that require ongoing medication support. He said that the Department of Social Services (DSS) does what they can, but as an individual with a history of incarceration it can be challenging to get things he needs, like appointments and medications, and it feels like an uphill fight to obtain care and to access basic social supports. • Dr. Rodgers commented that the important thing is to give people what they ask for, because they know what they need. She added that while quantitative data matters, all good research starts with a qualitative component. B. Measles Update Dr. Erica Pettigrew, Medical Director, presented an update on measles in the United States. Some highlights of her presentation are below: • The dramatic increase in life expectancy since the early 1900s is related to clean water, immunizations, and antibiotics, rather than advances in medical treatments. • Dr. Pettigrew reviewed the data around the sharp decrease in vaccine-preventable illness transmission after the introduction of the relevant vaccines. • Measles is one of the most transmissible and most contagious infections that we know of, and it can be transmitted through airborne, droplet, or touch. The three C's of measles are cough, coryza (nasal congestion), and conjunctivitis (pink eye). Koplik spots (spots in the mouth) do not always occur with measles, but when they do occur, the patient almost always has measles. The familiar rash does not typically appear until several days into infection, and measles initially presents as a cold. • There is no specific treatment for measles. Though some hospitals may use vitamin A as a treatment, Vitamin A in high doses can lead to toxicity and liver damage, so it should be used sparingly, typically only for hospitalized individuals in low-resource areas where children are more likely to have vitamin deficiencies. Vitamin A is not an effective prevention strategy for measles. • After the measles vaccine was introduced in 1963, measles cases plummeted. In 1989, there was a resurgence of measles cases, and it was recommended that children receive two doses (granting 97% effective generally lifelong immunity to measles). Currently, it is recommended that school-aged children and those at high risk receive two doses of the measles, mumps, and rubella (MMR) vaccine, while everyone else is recommended to receive one. Dr. Pettigrew added that they are advocating to change this to everyone receiving two doses regardless of age, as explaining the distinction is a hassle and the risk related to receiving an extra dose is negligible. • The term "eradication" in relation to communicable disease means that there is not ongoing community transmission for twelve months or longer. Measles was declared eradicated in the US in 2000, but this status may be revoked. • As of April 231, 2025, there are more than 800 cases of measles in the US, primarily concentrated in Texas or New Mexico. • In NC, there are two types of exemptions available for required vaccines for school-aged children: medical and religious. There are very few medical exemptions granted, while religious exemptions have been steadily increasing. • For herd immunity against measles, 95+% of the population needs to be vaccinated. As of 2023, only 92.5% of all kindergarteners in NC are in compliance with their MMR vaccines. In private/religious schools, around 9% of kindergarten students are S:\Managers Working Files\BOH\Agendas &Abstracts\2025 Agenda and Abstracts/ April Page 6